Coronavirus disease 2019(COVID-19)is a multi-system disease that can lead to various severe complications.Acute limb ischemia(ALI)has been increasingly recognized as a COVID-19-associated complication that often predi...Coronavirus disease 2019(COVID-19)is a multi-system disease that can lead to various severe complications.Acute limb ischemia(ALI)has been increasingly recognized as a COVID-19-associated complication that often predicts a poor prognosis.However,the pathophysiology and molecular mechanisms underlying COVID-19-associated ALI remain poorly understood.Hypercoagulability and thrombosis are considered important mechanisms,but we also emphasize the roles of vasospasm,hypoxia,and acidosis in the pathogenesis of the disease.The angiotensin-converting enzyme 2(ACE2)pathway,inflammation,and platelet activation may be important molecular mechanisms underlying these pathological changes induced by COVID-19.Furthermore,we discuss the hypotheses of risk factors for COVID-19-associated ALI from genetic,age,and gender perspectives based on our analysis of molecular mechanisms.Additionally,we summarize therapeutic approaches such as use of the interleukin-6(IL-6)blocker tocilizumab,calcium channel blockers,and angiotensin-converting enzyme inhibitors,providing insights for the future treatment of coronavirus-associated limb ischemic diseases.展开更多
Acral melanoma(AM)is the most common histologic subtype of melanoma in dark-skinned patients and is associated with a worse prognosis and a high mortality rate,largely due to the inconspicuous nature of early-stage le...Acral melanoma(AM)is the most common histologic subtype of melanoma in dark-skinned patients and is associated with a worse prognosis and a high mortality rate,largely due to the inconspicuous nature of early-stage lesions,which can lead to late diagnosis.Because of the overlapping clinical and histopathological features of AM with other forms of cutaneous melanomas,early detection of AM requires a multidisciplinary approach that integrates various diagnostic modalities,including clinical examination,dermoscopy,histopathology,molecular testing,radiological imaging,and blood tests.While surgery is the preferred method of treatment for AM,other therapeutic options may be employed based on the stage and underlying etiology of the disease.Immune checkpoint inhibitors,molecular targeted therapy,radiotherapy,chemotherapy,and oncolytic virotherapy represent promising advanced treatment options for AM.In this review,we provide an overview of the latest advancements in diagnostic and therapeutic methods for AM,highlighting the importance of early detection and the prompt,individualized management of this challenging disease.展开更多
基金supported by the Zhejiang Provincial Medical Scientific Research Program(No.2022RC136),China.
文摘Coronavirus disease 2019(COVID-19)is a multi-system disease that can lead to various severe complications.Acute limb ischemia(ALI)has been increasingly recognized as a COVID-19-associated complication that often predicts a poor prognosis.However,the pathophysiology and molecular mechanisms underlying COVID-19-associated ALI remain poorly understood.Hypercoagulability and thrombosis are considered important mechanisms,but we also emphasize the roles of vasospasm,hypoxia,and acidosis in the pathogenesis of the disease.The angiotensin-converting enzyme 2(ACE2)pathway,inflammation,and platelet activation may be important molecular mechanisms underlying these pathological changes induced by COVID-19.Furthermore,we discuss the hypotheses of risk factors for COVID-19-associated ALI from genetic,age,and gender perspectives based on our analysis of molecular mechanisms.Additionally,we summarize therapeutic approaches such as use of the interleukin-6(IL-6)blocker tocilizumab,calcium channel blockers,and angiotensin-converting enzyme inhibitors,providing insights for the future treatment of coronavirus-associated limb ischemic diseases.
基金This work was supported by the Zhejiang Provincial Natural Science Foundation of China(No.LS21H060001)the Alibaba Youth Studio Project(No.ZJU-032)the Zhejiang Province Medical and Health Science and Technology Program(Nos.2022KY1455 and 2022RC136).The funding bodies had no role in the design of the study,in collection,analysis,and interpretation of data,or in drafting the manuscript.We thank Fatima ALALIWI and Ma LING for their invaluable support and encouragement.
文摘Acral melanoma(AM)is the most common histologic subtype of melanoma in dark-skinned patients and is associated with a worse prognosis and a high mortality rate,largely due to the inconspicuous nature of early-stage lesions,which can lead to late diagnosis.Because of the overlapping clinical and histopathological features of AM with other forms of cutaneous melanomas,early detection of AM requires a multidisciplinary approach that integrates various diagnostic modalities,including clinical examination,dermoscopy,histopathology,molecular testing,radiological imaging,and blood tests.While surgery is the preferred method of treatment for AM,other therapeutic options may be employed based on the stage and underlying etiology of the disease.Immune checkpoint inhibitors,molecular targeted therapy,radiotherapy,chemotherapy,and oncolytic virotherapy represent promising advanced treatment options for AM.In this review,we provide an overview of the latest advancements in diagnostic and therapeutic methods for AM,highlighting the importance of early detection and the prompt,individualized management of this challenging disease.
